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目的分析双J管长期滞留原因,并探讨其预防与治疗的方法。方法 8例双J管长期滞留患者,先采用体外振波碎石,将输尿管末端体外牵引,然后行输尿管镜下气压弹道碎石或钬激光碎石,再试行拔除双J管。结果经上述治疗后所有患者滞留的双J管均拔除,除2例患者术后存在肾内结石残余以外,所有患者均未发生输尿管断裂及输尿管狭窄等并发症。结论患者遗忘拔管或对双J管滞留所致后果的严重性估计不足,以及医师在诊疗过程中责任心不强是发生双J管长期滞留的主要原因;输尿管镜下碎石拔管术可治疗双J管滞留,其中采用钬激光高频低能碎石能减少结石残余。
Objective To analyze the causes of long-term stay of double J tube and to explore its prevention and treatment methods. Methods Eight patients with long-term stay of double-J tube were treated with extracorporeal shock wave lithotripsy. The distal ureter was pulled in vitro and then treated by ureteroscopic pneumatic lithotripsy or holmium laser lithotripsy. Results All the double J tubes were removed after the above treatment. Except for the residual renal calculus in 2 patients, no complications such as ureteral rupture and ureteral stricture occurred in all patients. Conclusions The underestimation of exacerbation due to forgetful extubation or double J tube detention and the lack of accountability of physicians in the course of diagnosis and treatment are the main causes of long-term double-J tube detention. Ureteroscopic lithotripsy Treatment of double J tube retention, which uses holmium laser high-frequency low-energy stone can reduce the residual stones.